Congenital Toxoplasmosis and Long-term Outcomes

Objective

Congenital toxoplasmosis (CT) can have severe early and late sequelae in children. In this study, we aimed to evaluate the demographic, clinical, treatment characteristics of patients diagnosed with congenital Toxoplasma infection and to highlight the long-term complications of the patients.

Methods

Patients with CT were included in this study who were followed between 2010 and 2022 in Cukurova University Medical Faculty Hospital. Demographic, clinical and treatment characteristics were searched retrospectively. In the diagnosis of maternal and CT, Toxoplasma IgM, IgG, IgG avidity, T. gondii polymerase chain reaction tests were used along with clinical and symptoms.

Results

Eighteen children (two twins) with CT and their mothers (n=16) were included in the study. Median age was 1 month. Ten (55.5%) of the children were male. CT diagnosis was made during pregnancy in 7 mothers (resulting in 8 babies) and postnatally in 9 mothers (resulting in 10 babies). The mothers of 5 (31.1%) babies with CT received spiramycin treatment during pregnancy. Three (60%) of 5 pregnant women who received spiramycin were diagnosed in the first trimester, 4 (80%) of the babies did not have any sequale and only 1 (20%) had microphthalmia. Ocular involvement was the most common presentation of the disease occured in 10 patients (55.5%), hydrocephalus and intracranial calcification developed in five patients (27.7%). Hearing loss developed in 2 (11.1%) patients. During the follow-up period, seizures developed in 3 patients (16.6%), microcephaly in 2 patients (11.1%), and neurodevolopmental retardation in 7 patients (38.8%), two of the patients had severe mental retardation. One (5.5%) patient with hydrocephalus died at 36 months of age due to complications after ventriculoperitoneal shunt application.

Conclusion

In our study, we observed severe sequelae in vision, hearing, and neurodevelopmental aspects in children diagnosed with CT at birth and during follow-ups. Early diagnosis and treatment of infants, along with the detection of Toxoplasma infection during pregnancy, are essential in preventing severe sequelae that may arise due to CT.

Mpox (monkeypox): Diagnosis, prevention, and management in adults

ABSTRACT

Mpox (formerly "monkeypox") is a viral zoonosis that presents similarly to smallpox but is less contagious and causes less severe disease. Mpox may be transmitted from infected animals to humans through direct contact or a scratch or bite. Human-to-human transmission occurs through direct contact, respiratory droplets, and fomites. Two vaccines, JYNNEOS® and ACAM2000®, are currently available for postexposure prophylaxis as well as for prevention in certain populations at high risk for mpox. Most cases of mpox are self-limited; however, tecovirimat, brincidofovir, and cidofovir are available as treatments for at-risk populations.

Occurrence and risk assessment of pharmaceuticals in surface waters of the Middle East and North Africa: A review

Pharmaceutical compounds in surface water are perceived as contaminants of emerging concern due to their impacts on the aquatic environment and human health. The risk associated with these compounds has not been quantified in the Middle East and North Africa (MENA). This review identified that 210 pharmaceutical compounds have been analyzed in MENA water compartments between 2008 and 2022. In fact, 151 of these substances were detected in at least one of 13 MENA countries where occurrence studies had been conducted. Antibiotics claimed the highest number of pharmaceuticals detected with concentrations ranging between 0.03 and 66,400 ng/L (for Thiamphenicol and Spiramycin respectively). To investigate whether any of these compounds exert an ecological, human health, or antibiotic resistance risk, a screening-level risk assessment was performed in surface water matrices using maximum, median, and minimum concentrations. 39 and 8 detected pharmaceuticals in MENA surface waters posed a possible risk on aquatic ecosystems and human health respectively. Extremely high risk quotients (>1000) for six pharmaceuticals (17β estradiol, spiramycin, diclofenac, metoprolol, ethinylestradiol, and carbamazepine) were enumerated based on maximal concentrations implying an alarming risk on aquatic toxicity. Moreover, hormones posed the highest possible risk on human health whether ingested through drinking water or fish (e.g., 17β-estradiol had a health risk quotient of 2880 for children). Spiramycin showed a high risk of antibiotic resistance with a risk quotient of 133. This review serves as a basis for future prioritization studies and regulatory guidelines in the MENA region to minimize the risks of the identified compounds.

A high-performance SERS imprinted membrane based on Ag/CNTs for selective detection of spiramycin

In this test, the eggshell membrane (ESM) is selected as the support membrane for the biocompatibility and anchors CNTs on the surface to increase the mechanical properties. Then Ag NPs are decorated on CNTs-ESM substrate as SERS substrate by twice in-situ reduction. Finally, a layer of imprinted polymers is coated on the surface of the substrate to synthesize the imprinted membrane for selective detection of spiramycin. It is exhibited from the characteristic results that the CNTs significantly increase the mechanical properties and the detection sensitivity, simultaneously. When the concentration of SP changes between 10^-6 ∼ 10^-11 M, there is a linear relationship between SERS intensity and SP concentration. The detection limit is 10^-11 M, and the correlation coefficient R² is 0.9864. The SERS imprinted membrane can be applied into the detection of antibiotics in practical sample, which broadens the research field of antibiotics detection.

Influence of thermally activated peroxodisulfate pretreatment on gaseous emission, dissolved organic matter and maturity evolution during spiramycin fermentation residue composting

Aerobic composting combined with appropriate pretreatment is promising to achieve the utilization of antibiotics fermentation residues (AFRs). This research studied the effect of thermally activated peroxodisulfate (TAP) pretreatment on greenhouse gas (GHGs) emission, dissolved organic matter (DOM) and maturity evaluation during spiramycin fermentation residue (SFR) composting. Three treatments were conducted from co-composting of SFR and wheat straw, while 90% and 99.9% residual spirmycin removal pretreatment SFR by TAP were provided and compared with raw SFR. The cumulative CO₂ and NH₃ emissions increased by 17.2% and 30.8% after TAP pretreatment removed 99.9% residual spiramycin in SFR, while the cumulative CH₄ and N₂O emission decreased by 34.0% and 5.27%, respectively. The DOM, humic acid (HA)/fulvic acid (FA) and NH₄⁺/NO₃^- analysis confirmed that the composting maturity was improved with the increasing of HA and NO₃^- content by TAP pretreatment.

Application of Fourier transform-based algorithms to resolve spectral overlapping for UV spectrophotometric co-assay of spiramycin and metronidazole in tablets

Fourier transform-based algorithms were investigated to resolve UV spectral overlapping of spiramycin and metronidazole in binary mixtures. UV spectra and ratio spectra were both subjected to fast Fourier transform-based first-order differentiation and discrete Fourier transform {i.e. using trigonometric functions such as sin x_i - sin (x_i + 45⁰), cos x_i + cos (x_i + 45⁰), sin 2x_i - sin 2(x_i + 45⁰), cos 2x_i + cos 2(x_i + 45⁰), sin x_i - sin (x_i + 60⁰), cos x_i + cos (x_i + 60⁰)} that followed by 3 passes of 17-point triangular smooth. Such signal transforms generated linear calibration graphs for either drug in the concentration range of 6.25 - 25 mg/L with R² > 0.990. In comparison with the RP-HPLC reference method, the developed UV spectrophotometric methods had no significant difference in terms of accuracy and precision (p > 0.05) when quantifying spiramycin and metronidazole in their coated tablets. They are suggested as analytical quality control methods for their being environmentally friendly, technically simple, quick and economic.

Preparation of spiramycin fermentation residue derived biochar for effective adsorption of spiramycin from wastewater

Spiramycin (SPI) fermentation residue (SFR) is classified as hazardous waste in China because of the residual antibiotics in it. SFR disposal in the traditional way is costly and wasteful of resources. In this study, pyrolysis method was adopted to covert SFR to biochar for SPI removal from wastewater, and the SPI adsorption performance was investigated. The results showed that the optimal pyrolysis temperature was 700 °C as the prepared biochar BC700 exhibited the highest SPI removal efficiency. The specific surface area of BC700 was 451.68 m²/g, and the maximum adsorption capacity was 147.28 mg/g. The adsorption mechanism involved electrostatic interaction, pore filling, π-π interaction, hydrogen bonding, and the participation of C-C and O-CO functional groups in the adsorption. No residual SPI was detected in BC700 indicating the detoxification of SFR was achieved. Moreover, after recycling for 5 times, the SPI removal efficiency was still higher than 80.0%. Therefore, this study could provide a promising method for SFR disposal.

Insight into the evolution of antibiotic resistance genes and microbial community during spiramycin fermentation residue composting process after thermally activated peroxydisulfate pretreatment

Previous research has been demonstrated that the residual unextracted antibiotics in spiramycin fermentation residue (SFR) could be efficiently removed by thermally activated peroxodisulfate (TAP) pretreatment, indicating the improvement of biodegradability. This study aimed to investigate the effect of TAP pretreatment on the succession of bacterial community and fate of antibiotic resistance genes (ARGs) during SFR composting. Results indicated that TAP pretreatment increased the composting temperature and promoted the decomposition of organic matters. Furthermore, TAP pretreatment could increase bacterial alpha diversity and significantly reduce the relative abundance of ARGs (1.13-1.75 times) and mobile genetic elements (MGEs) (1.13-1.32 times) after composting. The compost of pretreated SFR by TAP could reduce the enrichment of ARGs and MGEs in the bacterial community, especially the rRNA methylase genes of ermB (4-142-folds). Redundancy analysis showed that Actinobacteria, Bacteroidetes, Proteobacteria and horizontal gene transfer mediated by MGEs (intI1) was positively related to the changes in ARGs (accounted for 97.4%). Network analysis showed that Firmicutes was the main bacterial hosts of ARGs and MGEs. These findings demonstrated that TAP pretreatment combined composting was a promising strategy for SFR safe treatment and disposal that could reduce the proliferation and transfer of ARGs.

Unusual Toxoplasma infection of the eye and central nervous system in an HIV-positive patient

OBJECTIVE

To report on a unique combination of cerebral toxoplasmosis and ocular toxoplasmosis in an HIV-positive patient in Slovakia.

METHODS

A 35-year-old heterosexual patient who presented with headache and major seizures underwent computed tomography (CT) and magnetic resonance imaging (MRI). Based on clinical findings, serological tests for toxoplasmosis were performed on serum and ocular fluid specimens. PCR was also used to detect Toxoplasma gondii and cytomegalovirus DNA. Goldmann and Witmer coefficient calculation was applied to demonstrate the synthesis of intraocular IgG antibodies.

RESULTS

CT and MRI revealed cystic lesions suspected of metastasis in the occipital and temporal regions, and we searched for the primary tumor. After vision loss in the left eye, which rapidly progressed to complete blindness, an eye examination detected macular edema. Anti-edema treatment was initiated. HIV positivity with a very low CD4 T-cell count (20/μL) was found, and the viral load was 100 400 HIV-RNA copies/ml. The serum was positive for anti-Toxoplasma IgG antibodies (> 200 IU/mL), IgM negative, and IgA borderline. As toxoplasmic encephalitis and retinitis were suspected, antitoxoplasmic therapy with pyrimethamine, spiramycin, and folinic acid was started. The ophthalmologist considered cytomegalovirus retinitis, which was not confirmed by serology or PCR. In contrast, the presence of IgG antibodies in ocular fluid and serum with the calculation of the Goldmann-Witmer coefficient (GW = 32) as well as PCR DNA positivity pointed to Toxoplasma gondii as the etiological agent. Follow-up MRI scan confirmed regression of the pathological lesions, neurological deficit also improved, CD4 T-lymphocytes increased above 200/μL, but blindness of the left eye persisted.

CONCLUSION

CT and MRI scans offered no clue as to Toxoplasma etiology of the brain and eye involvement in an HIV-positive patient, which was only confirmed by laboratory tests. Due to the delay in the diagnosis of toxoplasmosis, time from the epileptic seizure to treatment initiation was 16 days, which assumedly caused irreversible blindness in the patient.

Motivation of reactive oxidation species in peracetic acid by adding nanoscale zero-valent iron to synergic removal of spiramycin under ultraviolet irradiation: Mechanism and N-nitrosodimethylamine formation potential assessment

In this study, nanoscale zero-valent iron (nZVI) was added to motivate the functions of all the reactive oxidation species in peracetic acid (PAA) mixture under ultraviolet (UV) irradiation, and to enhance the removal of spiramycin, which is a typical precursor of N-nitrosodimethylamine (NDMA). Spiramycin (≤ 10 mg/L) could be completely removed within 20 min under the conditions of an initial pH of 4.0, a nZVI dose of 0.02 g/L and a PAA dose of 3.0 mg/L; additionally, 95.8% and 78.8% of PAA and H₂O₂ were consumed during the process. Electron paramagnetic resonance analysis and quenching experiments confirmed that 52.4% and 44.8% of spiramycin removal was contributed by hydroxyl radical (•OH) and carbon-centered radicals (R-C•), respectively; and Fe²⁺ released from nZVI played a critical role in radicals generation. Four degradation pathways of spiramycin were proposed and verified by the density of functional theory analysis. 65.2% of the NDMA formation potential (FP) was reduced after the reaction, and its residual was mainly contributed by the undegraded intermediate of dimethylamine. The results of multiple characterizations and continuous degradation experiments indicated that nZVI was stable in the system as the removal of spiramycin was hardly influenced even if reused three times. The nZVI/UV/PAA process is a promising advanced oxidation technology not only for the removal of refractory NDMA precursors (such as spiramycin) but also for significantly lowering the NDMA FP.

Heterogeneous activation of peroxydisulfate by sulfur-doped g-C3N4 under visible-light irradiation: Implications for the degradation of spiramycin and an assessment of N-nitrosodimethylamine formation potential

In this study, peroxydisulfate (PDS) was activated by synthesized sulfur-doped g-C₃N₄ (SCN) under visible-light irradiation and was adopted to enhance the removal of spiramycin, which is an important precursor of N-nitrosodimethylamine (NDMA). Specifically, 95.4% of spiramycin (≤10 mg/L) was removed in 60 min under the conditions of an initial value of pH of 7.0, an SCN dose of 1.0 g/L, and a PDS dose of 200 mg/L, and its degradation fitted well with the pseudo first-order kinetics. Electron paramagnetic resonance analysis and trapping experiments confirmed that ·O₂^- and h⁺ were the main oxidizers for the degradation of spiramycin, and ·SO₄^- and ·OH also participated in the removal of spiramycin. The removal of spiramycin in the PDS/SCN visible-light catalytic system occurred through three different pathways: aldehyde oxidation, cleavage of C-O bond and demethylation. Notably, 61.4% of NDMA formation potential (FP) was reduced after the reaction. The SCN catalyst was stable and its catalytic performance was excellent in the PDS/SCN system, as the spiramycin removal efficiency decreased only slightly from 95.4% to 87.3% after being reused three times. Therefore, our study not only provides an alternative method for removing spiramycin but can also can significantly reduce NDMA FP.

Schock and other complications after being bitten by a poisonous snake

The case report presents the case od 66-year-old woman with schock, severe general and grave local symptoms after a snake bite into the left limb. The species of attacking snake was not clearly specific, it should not have been clearly seen, but it was propably a common viper, a snake of viper family, which commonly occurs in our latitude. Due to the unclear origin of the bite, no specific antiserum and symptomatic treatment were given.

Conversion of biochar to sulfonated solid acid catalysts for spiramycin hydrolysis: Insights into the sulfonation process

Biochar has been recognized as a sustainable platform for developing functional materials including catalysts. This work demonstrated a method of converting biochar to sulfonated solid-acid catalysts, and the effectiveness of the catalysts for spiramycin hydrolysis was examined. Two biochar samples (H and X) were sulfonated with three reagents (concentrated H₂SO₄, ClSO₃H and p-toluenesulfonic acid (TsOH)) under hydrothermal, simple heating, ambient temperature, and CHCl₃-assisted treatments. The effect of elemental compositions and structural characteristics of the feeding materials (H and X) on the acidic properties of the sulfonated biochars were investigated. The results showed that the sulfonation ability of the three reagents was in the order of ClSO₃H > H₂SO₄ > TsOH, while hydrothermal treatment provided the highest total acidity, and largest amount of acidic groups (e.g., SO₃H, COOH and Ar-OH). Biochar X with higher O/C and N contents, and less graphitic features showed superior acidic properties than biochar H under all the employed treatments. The hydrolytic efficiencies of the sulfonated biochars under 200 W of microwave irradiation increased with increasing total acidity, and the amount of SO₃H and COOH groups. After sulfonation, the O/C of biochars increased, while H/C decreased, and the aromatic and graphitic features did not change. The electromagnetic energy absorbed by the sulfonated biochars did not notably contribute to spiramycin hydrolysis. Thus, this work demonstrated an effective and promising method for maneuvering biochar-based functional solid-acid catalysts for antibiotic remediation in contaminated water.

Minimum influent concentrations of oxytetracycline, streptomycin and spiramycin in selecting antibiotic resistance in biofilm type wastewater treatment systems

It has been demonstrated that antibiotic resistance could be induced and selected under high antibiotic concentrations in biological wastewater treatment systems. However, little is available regarding the minimum concentrations of antibiotics for selecting antibiotic resistance during wastewater treatment. Herein, the minimum influent concentrations of oxytetracycline, streptomycin, and spiramycin in selecting antibiotic resistance in biofilm type wastewater treatment systems were investigated by spiking respective antibiotic into wastewater with an antibiotic dose increasing from 0 to 0.1, 1, 5, 25, 50 mg/L stepwise over a period of 606 days. Significant increase (p < .01) in the total abundance of antibiotic resistance genes was observed for both streptomycin and oxytetracycline at a dose of 0.1 mg/L according to metagenomic sequencing, while the concentration levels leading to significant increases (p < .05) in resistant bacteria ratio were higher: 5 mg/L for streptomycin and 25 mg/L for oxytetracycline. Although resistome abundance increased with the increase of spiramycin dose, neither the corresponding Macrolide-Lincosamide-Streptogramin (MLS) resistance genes nor the resistant bacteria ratio showed perceptible increase. Partial canonical correspondence analysis showed that both bacterial community shift and mobile genetic elements alteration contributed to the enrichment of resistomes under the presence of streptomycin and oxytetracycline. Regarding spiramycin which is mainly targeting on Gram-positive bacteria, the dominance of the intrinsically resisting Gram-negative bacteria in the biofilm microbiota might be responsible for the vague change of MLS resistant determinants under the spiramycin stress. The results demonstrated that it is possible to prevent the development of antibiotic resistance during wastewater treatment by controlling the influent streptomycin and oxytetracyline concentrations below 0.1 mg/L. This work proposed an actionable approach for the management of antibiotic production wastewater.

Long-term exposure to antibiotic mixtures favors microcystin synthesis and release in Microcystis aeruginosa with different morphologies

The ecological risks of antibiotics in aquatic environments have raised great concerns worldwide, but the chronic effect of antibiotic contaminants on cyanotoxin production and release remains unclear. This study investigated the long-term combined effects of spiramycin (SP) and ampicillin (AMP) on microcystin (MC) production and release in both unicellular and colonial Microcystis aeruginosa (MA) through semi-continuous exposure test. At exposure concentration of 300 ng L^-1, MA growth rates were stimulated till the end of exponential phase accompanied with the up-regulation of photosynthesis-related gene. The exponential growth phases of unicellular and colonial MA were prolonged for 2 and 4 days, respectively. The stimulation rate of growth rate and MC content in unicellular MA were significantly higher than that in colonial MA. The highest concentrations of intracellular MC (IMC) and extracellular MC (EMC) were observed in the binary mixture at equivalent SP/AMP ratio (1:1). The promotion of IMC concentration was in consistent with the stimulated expression of MC-synthesis-related gene and nitrogen-transport-related gene. The malondialdehyde content and activities of superoxide dismutase and catalase in unicellular MA were significantly higher than those in colonial MA. The EMC concentration and the antioxidant responses of both unicellular and colonial MA significantly increased with exposure time. Long-term exposure to mixture of SA and AMP at environmentally relevant concentrations would aggravate the disturbance to aquatic ecosystem balance through the stimulation of MA proliferation as well as the promotion of MC production and release.

[Investigation for Filamentous Bacteria Community Diversity in Activated Sludge Under Various Kinds and Concentration Conditions of Antibiotics]

Three kinds of synthetic antibiotic (spiramycin, oxytetracycline, streptomycin) wastewater were continuously treated by parallel aerobic biofilm reactors for 6 months, respectively. Sludge bulking phenomenon caused by overgrowth of filamentous bacteria was observed under long-term high rbCOD and high C/N conditions in all reactors as showed by the Eikelboom and Jenkins examinations. The qualitative analysis of filamentous bacterial population in the biofilm and suspended sludge using fluorescence in situ hybridization (FISH) showed that the dominated filamentous bacteria in the bioreactor were N. limicola II and Thiothrix II. Under conditions of different antibiotic concentrations (5 mg x L(-1), 25 mg x L(-1)), there was no obvious change in the COD removal efficiency of the parallel reactors, while the NH4+ -N concentration (about 20 mg x L(-1)) occurred under high streptomycin concentration. The filamentous bacteria abundance was reduced with the increasing antibiotic concentration, especially significant for N. limicola II. Terramycin had a significant inhibitory effect on filamentous bacteria population, followed by Streptomycin and Spiramycin.

Abundance and distribution of Macrolide-Lincosamide-Streptogramin resistance genes in an anaerobic-aerobic system treating spiramycin production wastewater

The behaviors of the Macrolide-Lincosamide-Streptogramin (MLS) resistance genes were investigated in an anaerobic-aerobic pilot-scale system treating spiramycin (SPM) production wastewater. After screening fifteen typical MLS resistance genes with different mechanisms using conventional PCR, eight detected genes were determined by quantitative PCR, together with three mobile elements. Aerobic sludge in the pilot system exhibited a total relative abundance of MLS resistance genes (per 16S rRNA gene) 2.5 logs higher than those in control samples collected from sewage and inosine wastewater treatment systems (P < 0.05), implying the presence of SPM could induce the production of MLS resistance genes. However, the total relative gene abundance in anaerobic sludge (4.3 × 10(-1)) was lower than that in aerobic sludge (3.7 × 10(0)) despite of the higher SPM level in anaerobic reactor, showing the advantage of anaerobic treatment in reducing the production of MLS resistance genes. The rRNA methylase genes (erm(B), erm(F), erm(X)) were the most abundant in the aerobic sludge (5.3 × 10(-1)-1.7 × 10(0)), followed by esterase gene ere(A) (1.3 × 10(-1)) and phosphorylase gene mph(B) (5.7 × 10(-2)). In anaerobic sludge, erm(B), erm(F), ere(A), and msr(D) were the major ones (1.2 × 10(-2)-3.2 × 10(-1)). These MLS resistance genes (except for msr(D)) were positively correlated with Class 1 integron (r(2) = 0.74-0.93, P < 0.05), implying the significance of horizontal transfer in their proliferation.

[Studies on midecamycin 4"-O-propionyltransferase gene structure]

A BamHI-BamHI 8.0 kb DNA fragment which contains midecamycin propionyltransferase (mpt) gene was digested with different restriction enzymes and the restriction map was made. The mpt gene was localized in a EcoRI-EcoRI-PstI3.0 kb DNA fragment by Southern blot analysis using a 2.4 kb DNA fragment of the CarE gene as a probe. The 3.0 kb DNA fragment of mpt gene was cloned into E. coli/Streptomyces shuttle vector pWHM3 and a recombinant plasmid pWFPE was obtained. S. ambofaciens(pWFPE) and S. lividans(pWFPE) can convert endogenously synthesized or exogenously added spiramycin into 4"-O-propionylspiramycin, respectively. Sequence analysis of mpt gene demonstrated an open reading frame in the EcoRI-EcoRI-PstI3.0 kb DNA fragment, which starts with ATG and ends with TGA. Mpt gene encodes a product of 388 aa. G+C mol% of mpt is 68.0 and G+C mol% of 3rd codon position is 91.5. The putative product of mpt has a identity of 67.6% and a similarity of 86.4% with CarE product. A consensus RBS GAGGT in the 6bp upstream from ATG and a promoter region were found. An inverted repeat sequence in the downstream from TGA acts as transcriptional terminator.

Identification of tylosin in bovine muscle at the maximum residue limit level by liquid chromatography-mass spectrometry, using a particle beam interface

A particle beam liquid chromatography-mass spectrometric method is presented as a confirmatory technique for analysis of tylosin residues in bovine muscle. After chloroform extraction and a diol solid-phase extraction clean-up, on-line liquid chromatography-mass spectrometry (LC-MS) of extracts is carried out on an RP-18 bonded silica column. The analyte is introduced into the ion source by a particle beam interface and identified by negative chemical ionization with selective ion monitoring. The tylosin molecular ion is obtained with this ionization mode. The response of the ion chromatogram peak areas is linear for the three levels of spiked muscle analysed (0.5, 1 and 2 maximum residue limit). Under these LC-MS conditions, other macrolide antibiotics such as spiramycin and erythromycin do not interfere with tylosin.

Urticaria from erythromycin

We report an adverse cutaneous reaction (urticaria) due to erythromycin. A positive skin prick and leukocyte histamine release tests, as well as a positive single-blind, placebo controlled oral challenge to erythromycin, strongly suggest an IgE mediated hypersensitivity mechanism.

The role of adjunctive Rodogyl therapy in the treatment of advanced periodontal disease. A longitudinal clinical and microbiologic study

Several studies have indicated that the combination of metronidazole and spiramycin is synergistic against anaerobic bacteria and may be effective against oral infections. The present study sought to determine the efficacy and safety of a commercial preparation of these two antibiotics (Rodogyl) when used adjunctively in the treatment of advanced periodontal disease. In a double-blind parallel randomized trial, 56 patients (mean age = 44 years) with advanced periodontitis (50 of whom completed the study) were assigned to either the Rodogyl or placebo group. Both groups were thoroughly scaled and root planned for approximately 6 hours, with one group receiving Rodogyl for 2 weeks and the other a placebo. No other therapy was received during the study period. Two sites in each patient with probing depths of at least 7 mm were selected for study. Plaque level (P1I), gingival inflammation (GI), probing depth (PD), and attachment level (AL) were measured at baseline, 14 days, 1 month, and then at monthly intervals up to 6 months. Subgingival bacteria were monitored with dark-field microscopy. The development of resistant bacteria, as well as side effects to the medications, was also monitored. The Rodogyl group exhibited a greater gain in AL (0.67 mm) from the 2-month interval until the end of the study. Although this difference was statistically significant (P less than 0.05), it was not necessarily of biologic significance. There was a significantly greater decline in the proportion of spirochetes in the Rodogyl group at the 14-day interval, and this difference remained significant (P less than 0.05) at all study intervals. No difference in the proportion of motile organisms was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro activity of rodogyl against putative periodontopathic bacteria

The minimal inhibitory concentrations of Rodogyl (composite tablet of metronidazole and spiramycin), metronidazole-spiramycin mixture, spiramycin, metronidazole, and tetracycline were determined for selected putative periodontopathic microorganisms. Rodogyl was active against almost all strains, including Bacteroides species and the anaerobic spirochetes. Synergism of the component drugs in the Rodogyl combination was noted against Propionibacterium species. Spiramycin activity against Actinomyces species was enhanced in the presence of metronidazole.

Drug Resistance of Staphylococci II. Joint Elimination and Joint Transduction of the Determinants of Penicillinase Production and Resistance to Macrolide Antibiotics

Mitsuhashi, Susumu (Gunma University, Maebashi, Japan), Hajime Hashimoto, Megumi Kono, and Masato Morimura . Drug resistance of staphylococci. II. Joint elimination and joint transduction of the determinants of penicillinase production and resistance to macrolide antibiotics. J. Bacteriol. 89: 988–992. 1965.—Strains of Staphylococcus aureus , which show high resistance to macrolide antibiotics (erythromycin, oleandomycin, leucomycin, and spiramycin) and the capacity to produce penicillinase, have been isolated from clinical sources. The determinants of penicillinase production (PCase + ) and resistance to macrolide antibiotics (MAC r ) of these strains were irreversibly eliminated by treatment with acridine or with ultraviolet light. Among the 18 strains tested, PCase + and MAC r were eliminated from all strains except one, which lost only PCase + but not MAC r . The characters PCase + and MAC r were jointly transduced with the aid of phage lysates, obtained from the resistant donors by ultraviolet irradiation, into staphylococcal strains sensitive to PC and MAC. Segregation of PCase + and MAC r was rarely observed after transduction. From these results, it is suggested that the determinants of both PCase + and MAC r of staphylococci are located close together on a single genetic element, i.e., a plasmid (or episome), which exists extrachromosomally.